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Individual

MR. MAXWELL CHARLES POOLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 346-1500
(503) 346-1501
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(866) 617-6855
(503) 346-8015

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA214802
OR

Other

Enumeration date
05/18/2023
Last updated
09/13/2023
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